Private and public health insurance schemes impacting liver health and shaping experiences for autoimmune hepatitis patients at University Medical Center Hamburg-Eppendorf

Abstract

Background: Autoimmune hepatitis (AIH) is a chronic and progressive liver disease leading to inflammation and scarring of the liver. This study investigated the impact of the two health insurance schemes in Germany, public health insurance (PubHI) and pri-vate health insurance (PvtHI), on the liver health of AIH patients and assessed the differ-ence in overall Health-related quality of life (HrQoL) and satisfaction with the healthcare services. Methods: Data of this cross-sectional study was collected for 34 study participants (PubHI=17 and PvtHI=17). Three liver surrogates, AST, ALT, and IgG, were extracted from the R-LIVER registry at two different time points. Additionally, a survey was dis-tributed to collect data on HrQoL and satisfaction with healthcare. Group differences be-tween the two groups in liver health, HrQoL and satisfaction were tested. Results: No significant differences were observed between groups in the laboratory val-ues at baseline or at 1-year. There was a significant difference within groups after 1-year of treatment. Liver inflammation improved in both groups over time, where complete re-mission was achieved in PubHI (5/17) and PvtHI (10/17). There was no difference in the overall QoL between the two groups. However, a difference was found in satisfaction between the two insurance groups. Conclusion: In this pilot study, liver health and HrQoL between groups did not differ. Satisfaction with healthcare services differed between PubHI and PvtHI.